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Employed vs. Independent: Doctors Speak Out: Page 4 of 4

Employed vs. Independent: Doctors Speak Out: Page 4 of 4

From Employment to Independence

The ability to have a quality encounter with patients is why Landon Roussel, MD, an internist who runs his own DPC practice in Lutcher, La., left employment. At the age of 32, Roussel is a rare younger physician who runs his own practice. He says ever since residency, he only could see himself doing clinical medicine as an independent physician. 

But when he moved to Louisiana from Cambridge, Mass., he didn’t know anyone in the area and didn’t want to take out a loan to start his own practice. As such, he took an employed position as a hospitalist with a local hospital, in a contract designed to last one year.

Six months in, Roussel and the hospital agreed to amicably part ways. He didn't like the job, in particular having to hand his patients off to specialists, rather than tracking their condition on his own. He also just hated the hospital's focus on the bottom line, rather than the quality of the patient care.

"Hospitals wants to have high throughput and high quotas. That’s how they get paid. As a hospitalist, I had 15-20 patients on my roster per day, including a few discharges and admissions per day. You got paid for doing more; the quality was secondary. You get paid by CPTs codes, so if you can rack up more CPT codes that means more [relative value units], which means more compensation. That's the bottom line," Roussel says. "That's frustrating because RVUs don't translate to better patient [care]."

Being independent gives him peace of mind and the ability to create his own schedule, rather than chasing a carrot on a stick on a treadmill. In turn, he can provide better care to his patients, rather than seeing them as a means to fill a quota. Thus far, his DPC practice is half full and thanks to an aggressive marketing plan, he expects it to be completely booked within the next year.

Roussel and others say the time is ripe for physicians to go the independent route, thanks to the shortage of primary-care physicians. His advice to aspiring independent physicians is develop a knowledge of the business of medicine, form community relationships, and ultimately, understand that "people will move their feet to a good doctor." 


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